Bronchial mucormycosis, an unusual finding on bronchoscopy
Bronchial mucormycosis
Abstract
Mucormycosis is an infection caused by opportunistic fungi belonging to the order Mucorales. Since the SARS CoV 2 pandemic, warnings have been issued about the increase in the presentation of this infection. The presentation of tracheobronchial mucormycosis represents 37% of pulmonary involvement.
We present the clinical case of a diabetic patient with severe pneumonia due to SARS VOC 2, with unfavorable evolution, who was taken to bronchoscopy and found whitish pseudomembranes obstructing the lumen of the left main bronchus, confirming histopathologically the presence of mucormycosis.
A report of the present case is made to recognize the appearance of fungal infections in patients with poorly controlled diabetes and SARS COV 2 infection, who have a torpid evolution. The presence of white pseudomembranes should be an alarm sign to have this type of infections within the diagnostic possibilities.
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References
2. JC Laderas; AP Moreno; CP Salido, JC Arista; MJ Linares. Mucormicosis diseminadas en pacientes sin inmunodeficiencias: una enfermedad que también existe. Revista Iberoamericana de Micología. Vol. 32. Núm. 2.páginas 63-70 DOI: 10.1016/j.riam.2014.01.006
3. Guinea J, Canton E, Garcia-Rodriguez J, Martin-Mazuelos E, Pemán J. Métodos microbiológicos para el diagnóstico, manejo y estudio de la infección fúngica invasora. En: Cercenado E, Canton R, eds. Procedimientos en Microbiología Clínica. Madrid: SEIMC; 2012, cap 45. p.1-52. https://doi.org/10.1016/j.eimc.2013.01.008
4. U. Binder, C. Lass. Epidemiology of invasive fungal infections in the mediterranean area. Mediterr J Hematol Infect Dis, 3 (2011), pp. e20110016. http://dx.doi.org/10.4084/MJHID.2011.016
5. Selarka L, Sharma S, Saini D, Sharma S, Batra A, Waghmare VT, et al. Mucormycosis and COVID-19: An epidemic within a pandemic in India. Mycoses. 2021;64(10):1253–60. https://doi.org/10.1111/myc.13353
6. Organización Panamericana de la Salud / Organización Mundial de la Salud. Alerta Epidemiológica: Mucormicosis asociada a COVID-19. Washington, D.C. OPS/OMS. 2021
7. Hoenigl M, Seidel D, Carvalho A, Rudramurthy SM, Arastehfar A, Gangneux J-P, et al. The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries. The Lancet Microbe. 2022 1;3(7): e543–52. Available from: https://doi.org/10.1016/S2666-5247(21)00237-8
8. Kim KH, Choi YW, Jeon SC, Shin DH, Jung JI, Seo HS, et al. Mucormycosis of the central airways: CT findings in three patients. J Thorac Imaging. 1999 Jul;14(3):210–4. https://doi.org/10.1097/00005382-199907000-00009
9. He R, Hu C, Tang Y, Yang H, Cao L, Niu R. Report of 12 cases with tracheobronchial mucormycosis and a review. Clin Respir J. 2018 Apr;12(4):1651–60. https://doi.org/10.1111/crj.12724